New Study Shows ‘Significant Positive Economic Impact’ to State with Passage of Senate Bill 1354 by AzHHA

Greg Ensell, Vice President of Government Relations

The Arizona Hospital and Healthcare Association (AzHHA) commissioned a study to ascertain how the passage of a legislative proposal to combat the state’s severe physician shortage would affect the economy and patient access to care. The result of the independent economic-impact study, released today, shows “significant positive economic impact” to the state and expanded patient access to care over the next ten years if Arizona Senate Bill (SB) 1354 is passed.

The bill would enable hospitals across the state to increase the number of post-graduate physician residents they train through state funding that was cut more than a decade ago. The study, prepared by Rounds Consulting Group, Inc., shows that increasing the number of physician residents at three rural hospitals alone would result in 845 new highpaying jobs and $911 million in economic output over ten years.

“Although the study was limited to three hospitals, the same economics apply at the state level,” explains Jim Rounds, the consulting firm’s President and Chief Economist. “I’m certain further studies would show the statewide impact could be four or five times higher.”

The benefits of educating additional physician residents aren’t exclusively economic. Arizona’s primary care physician (PCP) shortage is one of the worst in the nation, meeting only 42% of the state’s PCP needs, according to the University of Arizona Center for Rural Healthcare. SB 1354 would also help eliminate the physician shortages that result in this limited access to care for patients statewide.

Additionally, the bill lessens the issue of physicians leaving Arizona after graduation because they are unable to secure the limited amount of in-state residency positions.

“Physicians stay where they train after graduation,” says Ann Marie Alameddin, President and CEO of AzHHA. “Almost 75% of medical students who finish post-graduate training in Arizona stay in Arizona. This means state funding for physician residencies will move the needle on the state’s physician shortage and be a game-changer for rural communities.”

In addition to restoring funding for physician residencies, SB 1354 also helps alleviate the physician shortage by appropriating state funds to four other programs: the University of Arizona Medical School, primary care provider loan repayment, medical student loan repayments and nurse training.

CMS Releases FY 2020 Payment Rules by AzHHA

Debbie Johnston, Senior Vice President of Policy Development

The Centers for Medicare & Medicaid Services (CMS) has released the proposed FY 2020 Medicare payment rules for inpatient prospective payment system (IPPS) hospitals, inpatient psychiatric facilities (IPF), inpatient rehabilitation facilities (IRF), long-term acute care (LTAC) hospitals, skilled nursing facilities (SNF), and hospice. AzHHA members will received detailed analyses in the coming weeks, including their facility-specific estimated impacts. A short overview of each rule follows:


The IPPS rule contains a net payment increase of 3.2% in FY 2020, compared to FY 2019, for hospitals that are meaningful users of electronic health records and submit quality measure data. Additionally, the rule makes changes to Disproportionate Share Hospital payments, new technology payments, the area wage index and quality incentive programs. Comments are due June 24th.


IPF rule contains a net payment increase of 1.7% and proposes one quality measure on medication continuation following discharge and requests comment on future topics for measurement. CMS will accept comments on through June 17th.


Under the IRF rule, net payments would increase 2.3% relative to FY 2019. The rule provides more detail about the revised IRF case mix groups (CMGs) that take effect in FY 2020 and provides updated impact data per IRF on the refined CMGs. CMS also proposes modifying one measure and adding two new process measures to the IRF Quality Reporting Program (QRP), and adopting 22 standardized patient assessment data elements, plus seven more data elements related to social determinants of health. In addition, the agency proposes to require IRFs to report patient assessment data for the QRP for all patients, regardless of payer. Comments are due June 17th.


Under the proposed LTAC rule, payments would increase by $37 million as compared to FY 2019. CMS also proposes to modify its quality measures to include, among other changes, seven more data elements related to social determinants of health. Comments will be accepted through June 24th.


CMS proposes a net payment increase of 2.5% compared to FY 2019. The rule also would implement a new SNF payment model that was finalized in last year’s rulemaking, which is expected to improve payments to hospital-based SNFs in FY 2020. For the SNF Quality Reporting Program, CMS proposes to modify one measure, adopt two new process measures and 22 standardized patient assessment data elements, plus seven more data elements related to social determinants of health. Comments are due June 18th.


Payment for hospice would increase by 3.2%, but this would be adjusted downward by a statutorily-required 0.5% productivity factor. The rule would also rebase the rates hospices are paid for certain types of care. In addition, the rule would modify the beneficiary hospice election statement by adding more information on the coverage implications of electing the benefit. CMS will accept comments through June 18th.

Grant Opportunity: Rural Communities Opioid Response Program by AzHHA

AzHHA Communications

The Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy (FORHP) will be releasing a Notice of Funding Opportunity (NOFO) for a new Rural Communities Opioid Response Program (RCORP) initiative called RCORP-Medication-Assisted Treatment Expansion (HRSA-19-102). HRSA plans to invest approximately $8 million in rural communities as part of this funding opportunity. Successful RCORP-Medication-Assisted Treatment Expansion (MAT Expansion) award recipients will receive up to $725,000 for a three-year period of performance to establish or expand medication-assisted treatment (MAT) in eligible hospitals, health clinics, or tribal organizations located in high-risk rural communities.

Eligible applicants include domestic public or private, non-profit or for-profit:

  • Rural Health Clinics, as defined by Social Security Act Section 1861(aa) and 42 CFR Parts 405 and 491

  • Critical Access Hospitals, as defined by Section 1820 (e) of the Social Security Act and 42 CFR 485 subpart F

  • Health Center Look-Alikes, defined as entities that meet all Health Center Program statutory, regulatory, and policy requirements but do not receive funding under section 330 of the Public Health Service Act, as amended (see for more information);

  • Other small rural hospitals with 49 available staffed beds or less, as reported on the hospitals’ most recently filed Medicare Cost Reports

  • Tribes or tribal organizations (excluding health centers that receive Health Center Program federal award funding)

For more details about this grant opportunity, click here.

Health Current Advisory Councils: Accepting Applications by AzHHA

AzHHA Communications

The annual appointment process is underway. If you or someone in your organization would like to be considered to serve on an advisory council, please complete and return the application. Completed applications must be submitted by May 14, 2019 to be considered in this round of appointments.

Health Current's governance structure includes three advisory councils that provide much needed input, involvement and support. The advisory councils are: Data Governance Council, Privacy & Security Council and Clinical Advisory Council. To view the list of current council members click here. The councils meet periodically throughout the year and agenda topics align with each Council's charter.

AzHHA Membership and Their Patients will Benefit from Partnership With PatientPing by AzHHA

John Koeneke, Vice President of Business Development

The AzHHA Affiliated Partners Program is happy to announce its new partnership with PatientPing, a Boston-based care coordination platform that reduces the cost of healthcare by seamlessly connecting providers to coordinate patient care. The statewide partnership will connect all of AzHHA’s member hospitals and participating providers. Participants will have access to real-time patient information and insights from care events across the entire continuum, enabling more seamless care transitions and overall improved care quality. “At AzHHA, we’re committed to improving care for patients across the state, and ensuring that our providers have the ability to coordinate care in real time will play an imperative role in that,” said Ann-Marie Alameddin, president and CEO of AzHHA. “Accessing PatientPing’s real-time, interoperable data will accelerate our state-wide care coordination efforts and ensure that we’re keeping with our mission to improve healthcare for Arizonans.” For more information about this new partnership, please contact John Koeneke or Zach Mitchell

Point of Pride: Tucson Medical Center by AzHHA

Tucson Medical Center (TMC) has partnered with El Rio Health to create a more family centered birthing process. A new in-hospital birthing unit with two delivery rooms will open in early July on the TMC campus. The new TMC Midwifery Center will provide a midwife-attended, family-centered experience for women who are low risk and want to have a natural, unmedicated birth. In addition, the center will offer water births, minimal interventions and support for the normal birthing process. Families will also continue to be discharged four to 12 hours after the baby is born.